1. Breast Cancer
SAFAD R. ISAM
MSN, COLLEGE OF NURSING, UNIVERSITY OF BAGHDAD

3. Cancer is a life-threatening disease. 80% to 90% of all cancers are the result of the
things we do to ourselves. Among women, breast cancer is the second most
common cancer.
Breast Cancer
Breast cancer is cancer that forms in the cells of the breasts.
It’s the most common malignant condition of breast.
It can occur in both men and women, but it's far more common in women.

4. Causes and Risk factors
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5.  New lump in the breast or underarm
 Thickening or swelling of part of the breast
 Mass which is hard with irregular borders
 Irritation or dimpling of breast skin
 Redness or flaky skin in the nipple area or breast
 Pulling in of the nipple or pain in the nipple area
 Nipple discharge other than breast milk
 Any change in the size or the shape of the breast
Clinical Manifestations

7. Types of Breast Cancer
Breast cancer is often divided into either:
 Non-invasive breast cancer (carcinoma in situ) – found in the ducts of the
breast (ductal carcinoma in situ) which has not spread into the breast tissue
surrounding the ducts.
 Invasive breast cancer – where the cancer cells have spread through the lining
of the ducts into the surrounding breast tissue.

8. Less common types…
 Male breast cancer
 Invasive (and pre-invasive)
lobular breast cancer
 Inflammatory breast cancer
 Paget's disease of the breast

11. Diagnostic Tests

12. Diagnostic Tests

13. Diagnostic Tests

14. Diagnostic Tests

15. Diagnostic Tests

16. Diagnostic Tests

17. Diagnostic Tests

18. Treatment
Side effects of chemotherapy in breast cancer
HOMEWORK
1. Chemotherapy
Chemotherapy uses drugs to destroy cancer cells.
Chemotherapy is sometimes given before surgery in
women with larger breast tumors.
Chemotherapy is also used in women whose cancer
has already spread to other parts of the body.

19. Treatment
2. Hormonal Therapy
Hormonal therapy is prescribed to women with
ER-positive breast cancer to block certain
hormones that fuel cancer growth.

20. Treatment
3. Radiotherapy
Is an effective treatment for most women who have
undergone lumpectomy and for some women who
have mastectomy surgery.
In these cases the purpose of radiation is to reduce the
chance that the cancer will recur.
Radiation therapy can be delivered by either:
 External beam radiotherapy
 Internal radiotherapy (brachytherapy)

21. Surgical Treatment
Lumpectomy
This is also referred to as breast- conserving therapy.
The surgeon removes the cancerous area and a surrounding margin of normal tissue.
A second incision may be made in order to remove the lymph nodes.

22. Surgical Treatment
Partial or Segmental Mastectomy Simple or Total Mastectomy

23. Surgical Treatment
Modified Radical Mastectomy

24. 1. Anxiety
related to diagnosis of breast cancer
2. Anticipatory Grieving
related to loss and possible or impending death
3. Acute Pain
related to tumor compression on nerve endings
4. Disturbed Sleep Pattern
related to pain and anxiety
5. Disturbed Body Image
related to loss of a body part
6. Sexual Dysfunction
related to body image or self-esteem disturbance
NURSING DIAGNOSES

25. NURSING INTERVENTION : PRE-OP
 Explain breast cancer and treatment options
 Reduce fear and anxiety and improve coping abilities
 Promote decision making abilities
 Provide routine pre-op care: Consent, NPO, Meds, Teaching about breathing exercise

26. NURSING INTERVENTION : POST-OP
 Position patient:
Supine,
Affected extremity elevated to reduce edema
 Relieve pain and discomfort:
Moderate elevation of extremity,
Injection of pain meds
Warm shower on 2nd day post-op

27. NURSING INTERVENTION : POST-OP
 Maintain skin integrity:
Immediate post-op: snug dressing with drainage
Maintain patency of drain (JP)
Monitor for hematoma within 12H and apply bandage and ice
Drainage is removed when the discharge is less than 30 ml in 24 H
Lotions, Creams are applied ONLY when the incision is healed in 4-6 weeks

28. NURSING INTERVENTION : POST-OP
 Promote activity:
Support operative site when moving
Hand, shoulder exercise done on 2 nd day
Post-op mastectomy exercise 20 mins
NO BP or IV procedure on operative site
Heavy lifting is avoided
Elevate the arm at the level of the heart
On a pillow for 45 minutes TID to relieve transient edema

29. NURSING INTERVENTION : POST-OP
Infection
• Monitor temperature, redness,
swelling and foul-odor
• IV antibiotics
• No procedure on affected extremity
 Manage complications:
Lymphedema
• 10-20% of patients
• Elevate arms, elbow above shoulder and hand
above elbow
• Hand exercise while elevated
• Refer to surgeon and physical therapist
Hematoma
• Notify the surgeon
• Apply bandage wrap and ICE pack

30. NURSING INTERVENTION : POST-OP
 Teach Follow-up care:
• Regular check-up
• Monthly BSE on the other breast
• Annual mammography

31. Prevention of Breast Cancer
 Get screened for breast cancer regularly
 Control your weight and Do regular exercise
 Know your family history of breast cancer
 Limit the amount of alcohol
 Avoid induced abortions
 Avoid unnecessary Medical radiation exposure
 Preventive mastectomy